Department of Epidemiology, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC;
Department of Exercise Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Clin Chem. 2019 Jan;65(1):108-118. doi: 10.1373/clinchem.2018.287623. Epub 2018 Nov 20.
Vascular age is an emerging health indicator and predictor of end-organ damage to the heart, brain, and kidney. Although there have been many review publications concerning risk factors for vascular aging, most include cross-sectional epidemiological studies, limiting inferences about temporality. There is a need for a review of longitudinal epidemiological studies with repeated measures of vascular structure and function to allow for a systematic examination of determinants of vascular age and the association of vascular aging with outcomes.
Arterial stiffness is the most frequently used measure of vascular aging. We report here results of an extensive literature review of longitudinal cohort studies with repeated measures of arterial stiffness to characterize determinants of vascular age. Additionally, we summarize population-based studies that have focused on the association of arterial stiffness with end-organ damage and adverse cardiovascular outcomes.
Changes in arterial stiffness are evident in early childhood. In adults, arterial stiffness has been observed to progress at the average rate of 0.2 to 0.7 m/s for every 5 years of life. The state of the science is limited by the small number of studies with repeated measures of arterial stiffness and determinants of arterial stiffness progression, as well as limited studies in children and diverse race/ethnic groups. Several extant studies suggest that beyond age, cardiometabolic risk factors and adverse lifestyle behaviors contribute to arterial stiffening. Therefore, arterial stiffness is important in the assessment of healthy vascular aging and a possible target for the prevention of subclinical and clinical disease.
血管年龄是一种新兴的健康指标，可预测心脏、大脑和肾脏等靶器官的损伤。虽然已经有许多关于血管老化危险因素的综述出版物，但大多数都包含横断面的流行病学研究，限制了对时间性的推断。需要对有血管结构和功能重复测量的纵向流行病学研究进行综述，以便系统地检查血管年龄的决定因素以及血管老化与结局的关系。
动脉僵硬度是最常用于测量血管老化的指标。我们在此报告了一项广泛的关于有动脉僵硬度重复测量的纵向队列研究的文献综述结果，以描述血管年龄的决定因素。此外，我们还总结了以动脉僵硬度与靶器官损伤和不良心血管结局的关系为重点的基于人群的研究。
动脉僵硬度的变化在儿童早期就很明显。在成年人中，动脉僵硬度的进展速度平均为每 5 岁增加 0.2 至 0.7 米/秒。该领域的科学现状受到以下因素的限制：有动脉僵硬度重复测量和动脉僵硬度进展决定因素的研究数量较少，以及在儿童和不同种族/族裔群体中的研究有限。一些现有的研究表明，除了年龄之外，心血管代谢危险因素和不良生活方式行为也会导致动脉僵硬。因此，动脉僵硬度在评估健康的血管老化和预防亚临床和临床疾病方面很重要。
